Lin Yu Chun, Tarrazzi Daler, Schoenbaum Todd, Knoernschild Kent
Assistant Professor, Department of Restorative Sciences, Dental College of Georgia at Augusta University, Augusta, GA.
Assistant Professor, Department of Restorative Sciences, Dental College of Georgia at Augusta University, Augusta, GA.
J Prosthet Dent. 2024 Aug 13. doi: 10.1016/j.prosdent.2024.07.016.
Limited data exist regarding the effects of postprocessing on the flexural strength of vat-polymerized additively manufactured (AM) interim fixed dental prostheses.
The purpose of this systematic review was to determine how the postprocessing workflow affects the mechanical properties of vat-polymerized additively manufactured interim fixed dental prostheses and to establish clinical guidelines.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The population, intervention, comparison, and outcome (PICO) question was "For vat-polymerized additively manufactured interim fixed dental prostheses (P), does varying the postprocessing workflow/ protocol (I and C) affect mechanical properties/physical properties/flexural strength (O)?" Searches were conducted in 3 databases: PubMed/Medline, EMBASE, and Web of Science, with 2 investigators performing the title and abstract screening and setting the inclusion and exclusion criteria to identify publications. The risk of bias was evaluated by applying the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies (nonrandomized experimental studies). The reported independent variables of rinse solution, rinse time, and polymerization time on the flexural strength results were extracted for qualitative review.
The initial search identified 149 records, with 12 in vitro studies meeting the inclusion criteria. Significant heterogeneity was observed in the manufacturing process and materials. Eleven of 12 included studies reported flexural strength above 100 MPa when following the manufacturer's recommendation. Postprocessing rinsing ranged from 5 seconds to 90 minutes, with potentially reduced flexural strength with extended rinsing. A rinse of 5 to 10 minutes was recommended for optimal mechanical properties, degree of conversion, and biocompatibility. Isopropyl alcohol (IPA) and tripropylene glycol monomethyl ether (TPM) were the most investigated rising solutions, while experimental solutions including 99.5% acetone and 100% bio-ethyl alcohol reportedly decreased flexural strength. Polymerization time and intensity correlated positively with the flexural strength, whereas an artificial aging process reduced the flexural strength.
Heterogeneity existed in the reported postprocessing protocols for AM interim fixed prostheses, including manufacturer materials, methods, and study outcomes. While polymerization time and intensity correlated with greater strength, consistent patterns regarding rinsing solution or time were lacking. Rinsing solution, extended rinsing time, and artificial aging may reduce flexural strength. Further investigation is indicated.
关于后处理对光固化增材制造的临时固定义齿弯曲强度的影响，现有数据有限。
本系统评价的目的是确定后处理工作流程如何影响光固化增材制造的临时固定义齿的力学性能，并建立临床指南。
遵循系统评价和Meta分析的首选报告项目（PRISMA）指南。人群、干预措施、对照和结局（PICO）问题为“对于光固化增材制造的临时固定义齿（P），改变后处理工作流程/方案（I和C）是否会影响力学性能/物理性能/弯曲强度（O）？”在3个数据库中进行检索：PubMed/Medline、EMBASE和科学网，由2名研究人员进行标题和摘要筛选，并设定纳入和排除标准以识别出版物。采用乔安娜·布里格斯研究所准实验研究（非随机实验研究）的批判性评价清单评估偏倚风险。提取报告的冲洗溶液、冲洗时间和聚合时间对弯曲强度结果的自变量进行定性评价。
初步检索确定了149条记录，其中12项体外研究符合纳入标准。在制造工艺和材料方面观察到显著的异质性。12项纳入研究中的11项报告称，遵循制造商的建议时，弯曲强度超过100MPa。后处理冲洗时间从5秒到90分钟不等，冲洗时间延长可能会降低弯曲强度。建议冲洗5至10分钟以获得最佳力学性能、转化率和生物相容性。异丙醇（IPA）和三丙二醇单甲醚（TPM）是研究最多的冲洗溶液，而据报道包括99.5%丙酮和100%生物乙醇在内的实验溶液会降低弯曲强度。聚合时间和强度与弯曲强度呈正相关，而人工老化过程会降低弯曲强度。
在报告的增材制造临时固定义齿的后处理方案中存在异质性，包括制造商材料、方法和研究结果。虽然聚合时间和强度与更高的强度相关，但缺乏关于冲洗溶液或时间的一致模式。冲洗溶液、延长冲洗时间和人工老化可能会降低弯曲强度。需要进一步研究。
